Individual
CHARLES JOHN NESSRALLA IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-4133
Mailing address
6 NICHOLS AVE, AVON, MA 02322-1710
(508) 942-4157
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
287448
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/26/2018
Last updated
01/12/2026
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